Communication Skills of Physicians and Patients’ Satisfaction

Abstract

Background:

The communication skills of physicians is an effective step of making effective relationship between doctor and patient. It plays essential role through diagnosis and treatment processes. This current study was performed to investigate the impact of communication skillfulness of physicians on patients’ satisfaction.

Methods:

A cross-sectional descriptive study was done to determine the impact of communication capability of practitioners on patients’ satisfaction. The DiMatto’s Patient Satisfaction Scale was administered among patients referring to the all 8 specialized clinics of Tabriz University of Medical Sciences. The validity and reliability of Persian translation of questionnaire of DiMatto’s Patient Satisfaction was verified by 10 specialists. The validity of the questionnaire was measured by content and structural analysis, and Cronbach’s alpha coefficients. The data were analyzed by software package of SPSS version 16 using Pearson’s correlation coefficient, U Mann-Whitney, Kruskal-wallis Test, Regression.

Results:

The study showed that there was a significant correlation between patients’ satisfaction and the communication skills of physicians (devoting the appropriate time for visiting the patients, explaining diagnosis and treatment procedures). In addition, the therapeutic skills of physicians, their friendly manners, respecting the patients’ feelings, and careful examination of patients by physician, revealed a significant correlation with patient satisfaction (P <0.05). However, we did not find strong correlation between effective listening to patients and patient’s satisfaction.

Conclusion:

Communication skills of physician play an important role on patients’ satisfaction; therefore, we propose strongly to improve the communication skills of physicians by improving the communication skills through related training courses.

1. INTRODUCTION

The effective correlation between physician and patient is a basic medical process. The physician’s ability to communicate friendly with his patient is considered to be the most important part of medical art and it is necessary for the physician to learn this ability (1, 2). The investigation of scientific and literary works indicates the unique role of communication between patient and physician. In most cases the healing effect of patient’s reliance on physician is more important than the recommended drug. When the patient is referring to the doctor’s, no one is as informed as the patient about his/her health and physical situation. If the physician had enough skill to communicate with his patient, he could get necessary information about physical and mental situation of patient. As a result, he could select the most suitable method of treatment.

Appropriate communication skill between physician and patient is the main part of clinical functions and construction the effective therapeutic physician-patient interpersonal relationship. It is called the heart and art of medication (1).

The effective relationship between physician and patient is named the basic medical treatment procedure. The physicians’ ability to communicate friendly with his/her patient is considered as the most important part of treatment improvement; therefore, it is the foremost necessary for the physician to learn and use this kind of abilities (2, 3). The investigation of scientific and literary works have indicated that friendly communication between patient and physician can play important role in driving the patients’ satisfaction. In most cases, the therapeutic process of patients is affected on the reliance of physician rather than the medics and/or recommended drugs. When the patient is referred to the doctor, no one is aware as the patient about his/her health and physical situation. If the physician takes enough communication-skills to communicate with his/her patients, S/he could get essential information about physical and mental situation of patients. As a result, s/he could take the most appropriate method for treating the patients. At present, the patients’ satisfaction is regarded as the main criterion for determining the quality of the therapeutic and health services. We may call the medical science as the combination of experience and art, in other words it is the combination of life-science and humanism. The medical education texts are focused on gaining communication and human skills, rather than learning the pure theoretical texts and materials (4). It is well-known that Patients’ satisfaction plays a key role in the medical services. The physicians’ appropriate communication skills can be regarded as the effective factor on this gratification. Communication ability is considered as an important skills of professionals in medical services (5). The medical competence of a physician is usually judged based on his/her communication skills. Learning the communication skills is one of the most important issues that should be considered in medical education systems. The individual relationship between physician and patient is a subjective skill that leads to sharing information, decision making, and therapeutic plans between them. The physicians who are not skilled in making communication with their patients may fall in a wrong cycle such as patients’ dissatisfaction, increased mistakes, misdiagnosing, increased costs of health care services, prescribing unnecessary drugs, wasting the time and money of patients, which may lead to the wrong treatment process. The consequence of such process is decreasing the quality of health services and treatments (6). The communication skills of physician can play a significant role in treatment process and may improve the treatment quality, but in some societies the communication skills of physicians are not considered appropriately due to the problems like: the lack of time for visiting patients, imbalance number of patients and the physicians, high rate of visiting fee for patients, that may cause the dissatisfaction of patient and probably falling their trust on physicians. The efficient communication skills of physicians such as effective listening to patient, showing friendly behavior and respects to the patients, certainly leads to the patients’ satisfaction and decreasing the fee of health-cares services.

The results of researches have indicated that in 60 to 80 percent of cases, diagnosing the diseases and selecting the accurate decision for treating the patients were obtained during the interviews and interpersonal communication between physician and patient (7). Although the health care services centers have been well-appointed with advanced techniques, but the emotional gap between physicians and patients are growing day after day.

Furthermore, the results of some studies have emphasized on the importance of the physician and patient interactive relationship and expressed that the lack of communicational skills among physicians is the most important factors which leads to the negligence of patients’ feelings. This has adversative effects on the ability of physicians to communicate efficiently with their patients (4). The communication skill of physicians is the major factor of preventing from prescriptions errors (8). Group visiting of patients and dedicating insufficient time to visit patients, are effective factors which lead to the dissatisfaction of patients.

The skill of tolerantly listening to the patients, would extremely help for creating a trustworthy relationship between physician and patient which is an essential step for therapeutic success (9). According to the statements of patients, the friendly communication of doctors are the most important sources of their mental and spiritual support (10). Effective communication with patient enables the physician to obtain detailed information from the patients’ condition and motivate the patients to follow the treatment plan. Finally, it could increase the role of the physician in health promotion and prevention from diseases. Many of doctors are not trained to communicate effectively with their patient; therefore, it is important to consider, the training of interaction and communication skills as an important part of medical education in the educational system of country. Due to the lack of appropriate information about the influence of doctors’ communication skills on patients’ satisfaction in developing countries, the current study was aimed at determining the effect of physicians’ communication skills on the satisfaction of patients, those who were referred to the clinics of Tabriz University of Medical Science during June to March 2015. The study also highlighted the most important factors in the relationship between doctor and patient that leaded to the patients’ satisfaction.

2. METHODS AND MATERIALS

The current study is a descriptive approach that carried out through June to March 2015. The investigated population consisted of 250 patients, who referred to the all 8 specialized clinics of Tabriz University of Medical Sciences. We selected the patients who referred to the physicians, specialized in cardiology, lungs, hematology, nephrology, infectious diseases, rheumatology, gastrointestinal, endocrine disorders and allergy. All participants in the study signed the satisfaction declaration for participating in the study.

Three doctors were selected for each of the mentioned specialties. There was only one specialist in the field of allergy, hence only one specialist in the field of allergy was selected. We selected ten patients referred to each specialist.

The selection of samples from population of under study was performed by (stratified) sampling method and Rand List 1.2 software. The DiMatto’s questionnaires were administered among patients; all items were clarified by the research assistant to the participants. various aspects of communication skills of physician were recorded by the researcher after the patients were visited by the physicians.

The (DiMatto’s) questionnaire contains 27 questions regarding to the communication skills of physicians. The Persian translation of DiMatto’s questionnaire was evaluate and verified by the specialists. For evaluation the content validity of the questionnaire, it was given to ten faculty members and their comments were applied to the final adjustment of questionnaire.

The collected data were analyzed statistically by the software package of SPSS version 16. The Pearson’s correlation coefficient tests, Regression, U Mann-Whitney, Kruskal-Wallis tests was used for analyzing the data. The amount of P-Value less than 0.05 was considered statistically meaningful. Study has been approved by the ethics committee of Tabriz University of Medical Sciences, and have been performed in accordance with the ethical standards as laid down in the 1964 Declaration of Helsinki and its later amendments or comparable ethical standards. All participants gave informed consent to their involvement in this study.

3. RESULTS

From a total number of 250 patients referred to the university clinics, 118 (42.2%) were males and 132 (52.8%) were females. 46 (18.4%) of them were singles, and 204 (81.6%) of them were married. From total amount, 126 (50.4%) of patients were referred from other cities in Iran, whereas 124 (49.6%) of them were living in Tabriz city.

Regarding to the education level of patients (40%) were uneducated or had finished only elementary school.

Analysis of data indicated that some factors led to increase in patients’ satisfaction such as: devoting sufficient time for visiting the patients, explanation of diagnosis and treatment processes, ability of medical skills, possessing the sufficient communication skills, the capability of skills for understanding the patients’ feelings, and the skill of making friendly relationship as well as confidential inter personal rapport with patients were the most important skills that derived the patients’ satisfactions.

Table 1.

Comparison of patients’ satisfaction based on patients’ gender

Table 2.

Comparison of patients’ satisfaction with communication skills of physicians based on marital status

Table 3.

Comparison of patient satisfaction regarding to the communication skills of doctors by location

Table 4.

Comparison of patients’ satisfaction based on the education levels

Table 5.

Description of indicators effecting on patients’ satisfaction

Table 6.

Relationship between physician skills and patients’ satisfaction

4. DISCUSSION

The communication skills of physicians play very important role in attracting the satisfaction and trustfulness of patients on their doctors. That is why the health-caring administers emphasize on training and promoting the communication skills of physicians. In fact, the communication skills of physicians are considered as core skills of health-caring services.

Since the majority of doctors take almost 200000 clinical advises through their medical occupation training, therefore earning the necessary capability of effective communication skills with patient, is essential part of improving the patients’ satisfaction and earning their trust in order to assure them to follow up the physicians’ orders. A study conducted by Aspergren on teaching and learning the communication skills for physicians showed that training the communication skills could improve the medication skills among physicians (11). Learning the communication skill is not only necessary for doctors but also for all people who are working in the health-care centers. Patients’ satisfaction is considered as the key advantage for physicians due to the sensitivity of their job, because their primary duty is to manage the stress of their patients before beaning the process of treatment.

The results of this current study indicated that there was a significant relationship between devoting enough time for visiting the patient and the satisfaction level of patients. Likewise, our findings the study of Gross et al. found a strong relationship between patients’ satisfaction and devoting the perfect visiting time by doctor (12). In addition, the results of our study showed a significant association between the length of visiting time and the patients’ satisfaction. However, there was not a meaningful association between effective listening of physician and patients’ satisfaction. The study of Rezaei et al. showed that there is a meaningful correlation between showing the interest by physician for listening to their patients and the satisfaction of patients (13). This difference may have happened due to the expectation level of studied populations.

Furthermore, explanation of diagnosis and treatment process, play important role in driving the satisfaction of patients. This is in consistence with the finding of study conducted by Suh (14). There was also high correlation between friendly behavior of physicians and satisfaction of patients. This is logical because everybody likes to be behaved respectful. The results of a study conducted by Korsch et al showed that there is a significant relationship between patients’ satisfaction and respectful behavior of physicians (15). Barbara et al. emphasized in their study that the lack of warmth and friendly communication of physicians, failure in taking into consideration the patient’s concerns and their expectations from medical visits, the lack of clear diagnosis explanation and causation of disease, and use of medical jargon lead significantly to the patient dissatisfaction (15).

5. CONCLUSION

The communication and interpersonal skills of physicians provide the ability to gather correct information from patients and help them in diagnosis, appropriate counselling, instructing the therapeutic plan, and establishing appropriate rapport between patient and physician (1).

The results of this study concluded that there was a direct correlation between the communication skills of doctors and their patients’ satisfaction. Regarding the positive results of skillfulness communication behavior on patients’ satisfactions, the health-care administers should provide the adequate facilities for training and learning of communication skills among physician regularly.